Background: We describe the demographic, clinical and laboratory findings along with the treatment and outcomes among children meeting the case definition of Pediatric Inflammatory Multisystem Syndrome-Temporally associated with SARS-CoV-2 (PIMS-TS). Methods: We analyzed the clinical and laboratory findings of children who presented with PIMS-TS during an 8-week period from May 4, 2020 to July 8, 2020. Results: We report 19 children with a median age of 6 year (IQR: 13 months-16 years), who met the case definition of PIMS-TS. All of them presented with fever. Multi organ involvement (79%), mucocutaneous involvement (74%), cardiovascular symptoms Conclusion: Children with PIMS-TS present with a wide range of signs and symptoms. Fewer children in this series had coronary artery abnormalities, and there was a low incidence of RT-PCR positivity with high presence of SARS-CoV-2 antibodies.

Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Indian context,it has been reported to be present in majority of children in spite of wide availability of sunlight. Recent guidelines have defined vitamin D status as severe deficiency, deficiency, sufficiency and risk for toxicity as 25(OH)D levels <5, <15, >20 and >50ng/mL, respectively.The manifestations of deficiency may vary from hypocalcemic seizures, tetany in infancy and adolescence to florid rickets in toddlers. Treatment is necessary for all individuals with deficiency whether symptomatic or not and consists of vitamin D supplementation as Stoss therapy or daily or weekly oral regimens with equal efficacy and safety, combined with calcium supplements. Routine supplementation starting from newborn period is being increasingly endorsed by various international organizations. Prevention by sensible sunlight exposure, food fortification and routine supplementation are the currently available options for tackling this nutritional deficiency.

Kawasaki disease (KD) is a common cause of cardiovascular morbidity in young children. No study has attempted to stratify risk factors for coronary artery involvement in Indian children. We attempted to study prospectively the risk factors for coronary involvement in children with KD in a tertiary care hospital between October 2009 and November 2011. The clinical details and investigations for all children admitted with KD were tabulated, and echocardiography was performed; 37 children were admitted with KD; and 8 children (21%) had coronary artery abnormalities. Prolonged fever, wider dispersion of symptoms, and pyuria were significantly associated with the development of coronary lesions. Clinical factors such as wider dispersion of symptoms and prolonged fever along with presence of pyuria can increase the risk of coronary lesions. The presence of these factors may help direct aggressive management and prevent loss of precious time.

An experiment of 150 days was conducted on 42 male Nellore lambs (28.3 +/- 0.64 kg) to determine the effect of zinc (Zn) supplementation (0,15, 30 and 45 ppm) in diet from inorganic (ZnSO(4)) and organic (Zn proteinate) sources on immune response and antioxidant enzyme activities by allotting them randomly to 7 groups in completely randomized design. The basal diet (BD) contained 29.28 ppm Zn. The humoral immune response assessed at 75 d against B. abortus was higher (P<0.01) with 15 or 30 ppm Zn supplementation from organic source. The dose and source had no effect on titres against chicken RBC antigen. The cell mediated immune response assessed as delayed type hypersensitivity (DTH) response against phytohaemagglutinin-P and in vitro lymphocyte proliferative response against concanavalin A at 150 d was higher (P<0.05) at 15 ppm Zn supplementation compared to BD fed lambs. Supplementation of 45 ppm Zn had no positive effect on immune response. The DTH response and antibody titres against B.abortus were higher (P< 0.05) on Zn proteinate compared to ZnSO(4) at 15 ppm Zn supplementation. The lipid peroxidase activity was lower (P < 0.01), while the RBC superoxide dismutase and catalase activities were higher (P < 0.01) in lambs at 15 ppm Zn supplementation compared to BD diet fed lambs, assessed at 75 d of feeding. Serum globulin concentration and alkaline phosphatase (ALP) activity (75 d of experiment) was higher in Zn supplemented lambs. The ALP activity increased (P < 0.01) with increase in Zn supplementation and being higher when supplementation was from Zn proteinate compared to ZnSO(4). The study indicated that 15 ppm zinc supplementation was required for obtaining higher immune response in lambs when fed a basal diet containing 29.28 ppm Zn and supplementation as Zn proteinate had higher antioxidant enzyme activities and immune response compared to ZnSO(4).

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Infections particularly Mycoplasma pneumoniae and HSV have been reported to be the commonest precipitating cause for Stevens Johnson syndrome (SJS) in children in developed countries and drugs are the commonest triggers reported in the Indian context. Intravenous immunoglobulin (IvIg) is emerging as a therapeutic option instead of glucocorticoids. The authors report a case of Stevens Johnson syndrome in association with Mycoplasma pneumoniae in a 5-y- old girl who recovered with IvIg therapy.